Table 6 Summary of clinical studies of platelet-rich plasma for treatment of degenerative cartilage lesions
From: Biology of platelet-rich plasma and its clinical application in cartilage repair
Level of evidencea | Patient number (age/range) | Intervention | Follow-up | Outcome | Adverse effects | Reference |
|---|---|---|---|---|---|---|
Level IV | 14 (18–87 years) | 3 L-PRP injections every 4 weeks | 12 m | Significant and linear improvement in KOOS. Pain reduced after movement and at rest | Modest pain persisting for days | [92] |
Level IV | 17 (30–70 years) | Single PRP injection | 12 m | Pain decreased, whereas function improved. MRI showed no worsening in 12 of 15 knees | Unreported | [93] |
Level IV | 27 (18–81 years) | 3 weekly L-PRP injections | 6 m | Substantial pain reduction after 1st injection and further improved at 6 months. WOMAC improved | No | [94] |
Level IV | 40 (33–84 years) | 3 weekly P-PRP injections | 6 m | Pain and disability subscores were significantly reduced | Transient sensation of hip heaviness | [95] |
Level IV | 50 (32–60 years) | 2 L-PRP injections every month | 12 m | IKDC and KOOS improved; all returned to previous activities | Unreported | [96] |
Level IV | 91 (24–82 years) | 3 injections of double-spun PRP activated by CaCl2 every 3 weeks | 12 m, 24 m | Pain decreased and knee function improved, especially in younger patients at 12 months. The improvements decreased at 24 months, but still better than the basal evaluation | Mild pain persisting for days | |
Level IV | 261 (mean 48Â years) | 3 injections of CaCl2-activated P-PRP every 2Â weeks | 6Â m | Significant differences in VAS, SF-36, WOMAC and Lequesne index | No | [99] |
Level III | 30 (36–76 years) | 3 injections of double-spun PRP inactivated PRP or HA every 3 weeks | 6 m | Both improved in IKDC, WOMAC and Lequesne index, but PRP exhibited better scores | Pain, swelling, but resolved in days | [100] |
Level III | 60 (61Â years in HA, 64Â years in PRP) | 3 weekly injections of CaCl2-activated P-PRP or HA | 5 w | 33.4% patients in PRP group and 10% in HA achieved at least 40% pain reduction. Disability reduced more in PRP group than HA | Mild self-limiting pain and effusion in both groups | [101] |
Level II | 120 (19–77 years) | 3 weekly L-PRP or HA injections | 6 m | Better results in WOMAC and NRS in PRP than HA | Temporary mild worsening of pain | [102] |
Level II | 150 (26–81 years) | 3 injections double-spun PRP or HA every 2 weeks | 6 m | Higher IKDC but lower VAS pain scores than HA, especially in younger patients | No | [103] |
Level II | 32 (18–60 years) | 3 injections of CaCl2-activated P-PRP or HA every 2 weeks | 7 m | Higher AOFAS but lower VAS pain scores than HA | Mild pain, but self-resolved | [104] |
Level I | 78 (33–80 years) | Single or twice leukocyte-filtered PRP injection, or single saline injection | 6 m | WOMAC improved after PRP injection, whereas worsened after saline infiltration | Self-resolved nausea and dizziness | [105] |
Level I | 120 (31–90 years) | 4 weekly injections of inactivated P-PRP or HA | 6 m | Significantly better clinical outcome and lower WOMAC scores than HA | None observed | [106] |
Level I | 176 (41–74 years) | 3 weekly injections of CaCl2-activated P-PRP or HA | 6 m | 14.1% more patients reduced pain at least 50% in PRP group, with a significant difference | Mild, evenly in 2 groups | [107] |
Level I | 96 (50–84 years) | 3 injections of CaCl2-activated P-PRP every 2 weeks, or single HA injection | 48 w | Significantly more efficient in reducing pain, stiffness and improving physical function than HA | Mild, evenly in 2 groups | [108] |
Level I | 109 (18–80 years) | 3 weekly injections of double-spun PRP releasate after freezing and thawing or HA | 12 m | No significant difference in all scores. Only a trend favoring PRP in patients with early OA | Mild pain and effusion | [109] |